A Tortured Twist on Ethics

George Orwell wisely observed that our understanding of the past, and the meaning associated with it, directly influences the future. And as the unprecedented public feud between the CIA and Congress makes clear, there are still significant aspects of our recent history of state-sponsored torture that need examination before we put this national disgrace behind us.

Important questions remain unresolved about the U.S. torture program in the aftermath of 9/11, questions that even the four-year, $40 million Senate Intelligence Committee report on CIA torture is unlikely to answer, if it is ever released.

For example, what will be done about doctors who helped create U.S. torture programs and participated in their implementation? And is there any evidence that cruel, inhuman, and degrading practices continue under official policy, even to this day?

The question of whether American health professionals previously involved in military torture programs should be allowed to quietly and freely continue their careers came to a head recently when it was revealed that the American Psychological Association (APA) refused to pursue ethics charges against psychologist John Leso. According to official and authoritative documents, Dr. Leso developed and helped to carry out “enhanced interrogation” techniques at Guantánamo Bay in 2002. Importantly, the APA has not disputed Leso’s role in the interrogation of detainee Mohammed Al-Qahtani, an interrogation that included being hooded, leashed, and treated like a dog; sleep deprivation; sexual humiliation; prolonged exposure to cold; forced nudity; and sustained isolation. In a subsequent investigation, Susan Crawford, a judge appointed under President George W. Bush, characterized this treatment of Al-Qahtani as “life-threatening” and meeting the legal definition of “torture.”

Over almost seven years, the APA—whose leadership has nurtured strong connections with the military and intelligence establishment—never brought the case to its full Ethics Committee for review and resolution. In defending this decision a few weeks ago, the APA Board released a statement explaining that a handful of top people with classified military access had determined that there was nothing unethical about Dr. Leso’s actions and that the case should be immediately closed.

What exactly is the interest of the leaders of the world’s largest professional association of psychologists in blocking investigation into torture? And should psychologists who participated in torture have this dark chapter of their careers wiped clean without censure?

Ethical imperatives to “do no harm” and sanctions for psychologists who break the rules—from sleeping with patients to insurance fraud to not informing research subjects of their rights—exist not only to protect the public but also to provide clear guidance to professionals faced with moral dilemmas. Yet when considering ethical complaints, the APA apparently takes involvement in torture less seriously than these other transgressions.

If such ethical parameters are effectively nullified, what kind of future might we expect?

Here’s an equally important question: Has U.S. torture really ended? While the Obama Administration made an early display of banning some of the worst techniques that had been given the official seal of approval under Bush and Cheney, such as waterboarding, the U.S. military continues to engage in cruel, inhuman, and degrading practices. As the lawsuit brought this month by Imad Hassan in federal court reminds us, the force-feeding of Guantánamo hunger strikers there is continuing despite a military blackout since December on the number of inmates engaged in that protest. Human rights and medical organizations have widely denounced this brutal practice.

Even more under the radar, Appendix M of the current Army Field Manual on interrogations makes a distinction between legitimate methods for POWs covered under the Geneva Conventions and separate, special techniques reserved for “enemy combatants,” that old Bush-era trope. The language in Appendix M twists itself in a knot trying to avoid the appearance of prescribing torture or other abuses, but the hypocrisy is plain. Detainees can be limited to only four hours of sleep per day, forced to undergo sensory deprivation, and placed in prolonged solitary confinement, indefinitely. Long-term isolation is now well-known to cause severe psychiatric suffering, including psychosis and suicidal behavior, in people with no previous problems. Independent human rights groups and the UN Special Rapporteur on Torture have described such practices as forms of torture and called for strict bans on their use.

Before we tell ourselves it’s time to put our history of torture behind us, we should take a hard look in the mirror. What does it mean for our society to allow health professionals who have been involved with torture to subsequently practice with impunity? Have we really repaired the damage done by the torture program, or is it ongoing? Do official abuses continue under our noses? Like all civilized societies, we must reckon with past and present truths—if we want to be in control of our future.

your doctors, your nurses, broke the most sacred oath of all doctors .. end of the day no more than Mengele the nazi doctor in the death camps.. when he experimented on the Jews. so whats a few muslims really, sadly the world will see american doctors not as champions but as tools for the american armed forces, doctors that tortured, that used there skills to cause pain and suffering, what can you say?? you cant say that American Medicine community didnt know?? you are all to blame (well was anything done to stop it) So a buring tower in New york made you throw out all humanity for revenge ,therefore Osama won, he forced america to give up her greatest tresure her beloved freedom.

Hippocratic Oath
I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Dr. Brody's article is one of the best I have seen about this issue. I am also a member of Psychologists for Social Responsibility. I am appalled at the American Psychological's lack of leadership on condemning psychologists who have had any part in torturing of the detainees at Guantanamo. Many of us have tried to get the APA to take a stand, and yet, they still protect the few that are involved in this horrific behavior. I quit the American Psychological Association many years ago, along with 1000 other psychologists, because they would not take a stand. And, they still won't. Until we, as a profession, and we, as a society, demand that human beings not be tortured, and those who do it be punished, torture will continue. Thank you, Yosef, for this powerful article. It is worth sharing far and wide.
Lorri Greene, Ph.D.
Psychologist
San Diego, Ca

You all believe that these people are to be punished, that they broke rules, that they lost their morals. But what if you are blaming the innocent? How are you to know which doctors/psychologists participated? So, if you don't know, you are to condemn all? If you do know, why should these people be subject to punishment when you don't know the circumstances and the obligations these people have? People of the United States have freedom, a lot of it. They are not under just one ruler who dictates what they do or say; they are under a group of people representing the majority of population. America has not lost her freedom.
And quite frankly, who is to say they lost humanity? Maybe, human's view of morality is corrupt, or even made up. It could be a figment of imagination that was one day created and everyone followed. Everyone has a different view on morality anyways; why should anyone force their own moral beliefs on another or worse a whole group of people? Some people believe being gay is wrong, and some believe in racism. Everyone in America has a right to freedom; why are you going to take it away? Are you going to force everyone to share one moral belief? If not, then let America be free. Do not judge, but try to understand.
If you are a psychologist, isn't that your job to understand people? Why are you not doing just that? Instead you judge others and sit here complaining about an issue that you are doing anything about if you truly believe in it. The only freedom Americans lost is their freedom to do something about what they believe in. Americans can speak all they want, but they'll never do anything about it except a small few.
If you don't believe in torture, don't just write on here about it. You can write to the people about it, sure, but don't forget to write to politicians about it. Write to the people where the issue matters, where they have a say in what to do about it.

That you based your "American" society on so called values of freedom.. yet you manipulate them, change them to what ever you believe at the time. Is that not true ?? you waged war against british empire yet enslaved the africans, war against the spainish for land, you wanted the land of the first nations and so manifest destiny then the first death marchs on the road of many tears. the essence is clear, freedom is a necessary convenience to americans and always will be, the horrors of hiroshima or nagasaki will they always be dwarfed by the horrors of 911.

what you call freedom some people call control, today are the noble sioux or cheyanne on there native ancestral lands, no honestly?? second class in a land where all are equal.

but will say this if i have offended you, then i apologise my point i was making, that these people, these so call doctors gave an oath, sworn to god almighty to protect the innocent. doctors that have sworn not to cause pain or suffering and they did it, willingly, knowingly, it was not only condoned by the state that outlawed torture.

i dont know where you come from if you make an oath? where we come from we take oaths to god seriously.

p.s i love american people this is meerly a debate people, you will always be a great people, a nation of great people, when i look at america, its like looking at a young man that doesnt see his potential, you tell him, doesnt listen "what ever..go away"